Opinion

Those who live with Alzheimer’s disease face a massive stigma, and I am afraid that some will feel discouraged about speaking out on their own behalf, writes Richard Kennedy of Lorton, Va., in a letter to the editors of the Washington Post.

A 2014 article in the Journal of Alzheimer’s Disease that found that THC, the psychoactive component in marijuana, at low doses, “may slow or halt the progression of Alzheimer’s disease,” Kennedy states.

Since District of Columbia residents can legally obtain medical marijuana for conditions with a doctor’s approval, and considering the lack of effective treatments for Alzheimer’s and marijuana’s relative safety compared with many pharmaceuticals, it is an option worth considering.

The writer is a member of the steering committee of Safe Access-DC, an organization that advocates for access to medical marijuana.

Peter Lomonaco, co-founder of the Alaska Cannabis Club, prepares a joint at the medical marijuana dispensary in Anchorage, Alaska. On Tuesday, Feb. 24, 2015, Alaska became the third state in the nation to legalize marijuana. (AP Photo/Mark Thiessen)

By Christopher Ingraham

In three key swing states, marijuana legalization is more popular than any potential 2016 presidential contender. That’s according to a Quinnipiac University poll conducted in March.

More than 80 percent of adults in Ohio, Pennsylvania and Florida support medical marijuana, according to the survey. Fifty one percent of Pennsylvanians, 52 percent of Ohioans and 55 percent of Floridians also support legalizing small amounts of marijuana for personal use.

Recreational weed is polling just a hair better than Hillary Clinton in all three states — she’s currently pulling favorability numbers in the high-40s, low-50s range.

And marijuana is considerably more popular than any of the major Republican candidates. In Ohio, for instance, recreational marijuana outpolls Marco Rubio and Ted Cruz by more than two-to-one. In Pennsylvania, medical marijuana is more than three times more popular than Jeb Bush. Home-state favorites Bush and Rubio poll better in Florida, but they’re still running 8 to 13 points behind recreational marijuana.

Granted, I’m employing some sleight-of-hand here. Marijuana legalization is an issue and candidates are people. You can’t really compare them in an apples-to-apples way like this.

Still, though, the numbers illustrate two facts: the continued support for liberalizing marijuana laws, and the ambiguity around presidential candidates that you’d expect more than a year out from the election — after all, Darth Vader was polling better than the 2016 field as of last year.

Another important point: on marijuana in particular, high polling numbers don’t necessarily translate into election victories. In Florida, for instance, 88 percent of voters said they supported medical marijuana last July. But the state’s constitutional amendment to allow medical marijuana failed to gather the 60 percent support it needed to become law last November .

Medical marijuana proponents are already working to put the issue back on the Florida ballot in 2016, when the electorate will likely be younger and more liberal — perhaps just enough to push it over that 60 percent threshold. A group in Ohio wants to put full marijuana legalization before voters this November. And marijuana will likely show up on the ballot in at least six other states in 2016, including California, Nevada and Arizona.

All of which adds up to the fact that marijuana will be a mainstream election issue that 2016 candidates will need to grapple with, according to John Hudak of the Brookings Institution. Some Republicans are eager to frame the topic as a states-rights issue, while others, like Rand Paul, approach it from the standpoint of criminal justice reform and fiscal responsibility. Democrats can capitalize on the issue to reach out to their young voter base and engage them on questions of social and racial justice.

Overall, Hudak concludes that “in some ways marijuana policy is the perfect issue for a presidential campaign. It has far reaching consequences that both parties have reason to engage.” While it won’t rise to the level of a litmus test issue for most voters, candidates won’t be able to avoid talking about it — or they’ll do so at their own peril.
Christopher Ingraham writes about politics, drug policy and all things data. He previously worked at the Brookings Institution and the Pew Research Center.

In three key swing states, marijuana legalization is more popular than any potential 2016 presidential contender. That’s according to a Quinnipiac University poll conducted in March.

More than 80 percent of adults in Ohio, Pennsylvania and Florida support medical marijuana, according to the survey. Fifty one percent of Pennsylvanians, 52 percent of Ohioans and 55 percent of Floridians also support legalizing small amounts of marijuana for personal use.

Recreational weed is polling just a hair better than Hillary Clinton in all three states — she’s currently pulling favorability numbers in the high-40s, low-50s range. And marijuana is considerably more popular than any of the major Republican candidates. In Ohio, for instance, recreational marijuana outpolls Marco Rubio and Ted Cruz by more than two-to-one. In Pennsylvania, medical marijuana is more than three times more popular than Jeb Bush. Home-state favorites Bush and Rubio poll better in Florida, but they’re still running 8 to 13 points behind recreational marijuana.

Granted, I’m employing some sleight-of-hand here. Marijuana legalization is an issue and candidates are people. You can’t really compare them in an apples-to-apples way like this.

Still, though, the numbers illustrate two facts: the continued support for liberalizing marijuana laws, and the ambiguity around presidential candidates that you’d expect more than a year out from the election — after all, Darth Vader was polling better than the 2016 field as of last year.

Another important point: on marijuana in particular, high polling numbers don’t necessarily translate into election victories. In Florida, for instance, 88 percent of voters said they supported medical marijuana last July. But the state’s constitutional amendment to allow medical marijuana failed to gather the 60 percent support it needed to become law last November .

Medical marijuana proponents are already working to put the issue back on the Florida ballot in 2016, when the electorate will likely be younger and more liberal — perhaps just enough to push it over that 60 percent threshold. A group in Ohio wants to put full marijuana legalization before voters this November. And marijuana will likely show up on the ballot in at least six other states in 2016, including California, Nevada and Arizona.

All of which adds up to the fact that marijuana will be a mainstream election issue that 2016 candidates will need to grapple with, according to John Hudak of the Brookings Institution. Some Republicans are eager to frame the topic as a states-rights issue, while others, like Rand Paul, approach it from the standpoint of criminal justice reform and fiscal responsibility. Democrats can capitalize on the issue to reach out to their young voter base and engage them on questions of social and racial justice.

Overall, Hudak concludes that “in some ways marijuana policy is the perfect issue for a presidential campaign. It has far reaching consequences that both parties have reason to engage.” While it won’t rise to the level of a litmus test issue for most voters, candidates won’t be able to avoid talking about it — or they’ll do so at their own peril.

Skiers and snowboarders take a run at Breckenridge, in Colo. Business is booming in Colorado’s mountain resorts, and the addition of recreational marijuana stores this year has attracted droves of customers curious about legalized pot.(AP Photo/Brennan Linsley)

After Colorado voters legalized marijuana, they also approved heavily taxing it and using the money for school construction, law enforcement, drug education and other useful things.

The arrangement made perfect sense.

But now the 15-month-old experiment has entered a phase that makes no sense at all. It’s the prospect that all this new marijuana revenue — an estimated $58 million in the current fiscal year — may have to be returned to the voters, because of a provision in the state’s Constitution that rigidly constrains taxes and spending. The provision is the Taxpayer’s Bill of Rights, or Tabor, a complex set of rules that requires, among other things, voter approval of all new taxes and automatic refunds if tax revenues or spending exceed estimates given when tax questions are put to the voters.

As an April 1 report in The Times explained, Colorado’s tax revenues have recently surged, thanks in part to the booming construction, oil and gas industries, in addition to some $58 million from the marijuana taxes. But not only revenues but overall state spending this year are expected to end up higher than the state estimated back when the marijuana tax was on the ballot. Under Tabor — which some in Colorado have likened to a fiscal straitjacket or a statutory version of the crazed space computer HAL 9000 — the state is therefore required to refund the marijuana money.

But lawmakers don’t want to give the money back. They argue that marijuana was always supposed to pay for itself, that school spending in particular is a vital public priority and that the general fund should not be tapped to make up for one missed revenue estimate. They are also vexed by the question of who should get the money — weed growers and buyers, or the general public? — and how to give it back.

Lawmakers are now scrambling to put together a bill that would let them go back to the voters with a ballot measure asking their permission to keep the marijuana money. Whether voters will grant it is unclear.

Since marijuana legalization took effect last year, Colorado has made impressive gains in setting up a new industry and maintaining public support for it, despite the administrative challenges and the ominous threat of federal intrusion. Tabor was added to the state Constitution in 1992 by voters who bought its seductive argument that government needs shrinking, always and forever. Ever since, lawmakers and concerned citizens have lamented the constraints Tabor has placed on the state’s ability to adequately and flexibly fund pressing public needs, like infrastructure and education, or to save for rainy days.

The bill now being cobbled together could lead to a short-term fix allowing the marijuana money to be retained and usefully spent. A more lasting repair will come when voters undo the damage that anti-tax zealotry did to their Constitution.

Partygoers listen to live music and smoke pot on the second of two days at the annual 4/20 marijuana festival in Denver, Sunday April 20, 2014. The annual event is the first 420 marijuana celebration since retail marijuana stores began selling in January 2014. (AP Photo/Brennan Linsley)

By Aaron E. Carroll

As my children, and my friends’ children, are getting older, a question that comes up again and again from friends is this: Which would I rather my children use – alcohol or marijuana?

The immediate answer, of course, is “neither.” But no parent accepts that. It’s assumed, and not incorrectly, that the vast majority of adolescents will try one or the other, especially when they go to college. So they press me further.

The easy answer is to demonize marijuana. It’s illegal, after all. Moreover, its potential downsides are well known. Scans show that marijuana use is associated with potential changes in the brain. It’s associated with increases in the risk of psychosis. It may be associated with changes in lung function or long-term cancer risk, even though a growing body of evidence says that seems unlikely. It can harm memory, it’s associated with lower academic achievement, and its use is linked to less success later in life.

But these are all associations, not known causal pathways. It may be, for instance, that people predisposed to psychosis are more likely to use pot. We don’t know. Moreover, all of these potential dangers seem scary only when viewed in isolation. Put them next to alcohol, and everything looks different.

Because marijuana is illegal, the first thing I think about before answering is crime. In many states, being caught with marijuana is much worse than being caught with alcohol while underage. But ignoring the relationship between alcohol and crime is a big mistake. The National Council on Alcoholism and Drug Dependence reports that alcohol use is a factor in 40 percent of all violent crimes in the United States, including 37 percent of rapes and 27 percent of aggravated assaults.

No such association has been found among marijuana users. Although there are studies that can link marijuana to crime, it’s almost all centered on its illegal distribution. People who are high are not committing violence.

People will argue that casual use isn’t the issue; it’s abuse that’s worrisome for crime. They’re right – but for alcohol. A recent study in Pediatrics investigated the factors associated with death in delinquent youths. Researchers found that about 19 percent of delinquent males and 11 percent of delinquent females had an alcohol use disorder. Further, they found that even five years after detention, those with an alcohol use disorder had a 4.7 times greater risk of death from external causes, like homicide, than those without an alcohol disorder.

When I’m debating my answer, I think about health as well. Once again, there’s no comparison. Binge drinking accounted for about half of the more than 80,000 alcohol-related deaths in the United States in 2010, according to a 2012 report by the Centers for Disease Control and Prevention. The economic costs associated with excessive alcohol consumption in the United States were estimated to be about $225 billion. Binge drinking, defined as four or more drinks for women and five or more drinks for men on a single occasion, isn’t rare either. More than 17 percent of all people in the United States are binge drinkers, and more than 28 percent of people ages 18-24.

Binge drinking is more common among people with a household income of at least $75,000. This is a solid middle-class problem.

Marijuana, on the other hand, kills almost no one. The number of deaths attributed to marijuana use is pretty much zero. A study that tracked more than 45,000 Swedes for 15 years found no increase in mortality in those who used marijuana, after controlling for other factors. Another study published in the American Journal of Public Health followed more than 65,000 people in the United States and found that marijuana use had no effect at all on mortality in healthy men and women.

I think about which is more dangerous when driving. A 2013 case-control study found that marijuana use increased the odds of being in a fatal crash by 83 percent. But adding alcohol to drug use increased the odds of a fatal crash by more than 2,200 percent. A more recent study found that, after controlling for various factors, a detectable amount of THC, the active ingredient in pot, in the blood did not increase the risk of accidents at all. Having a blood alcohol level of at least 0.05 percent, though, increased the odds of being in a crash by 575 percent.

I think about which substance might put young people at risk for being hurt by others. That’s where things become even more stark. In 1995 alone, college students reported more than 460,000 alcohol-related incidents of violence in the United States. A 2011 prospective study found that mental and physical dating abuse were more common on drinking days among college students. On the other hand, a 2014 study looking at marijuana use and intimate partner violence in the first nine years of marriage found that those who used marijuana had lower rates of such violence. Indeed, the men who used marijuana the most were the least likely to commit violence against a partner.

Most people come out of college not dependent on the substances they experimented with there. But some do. So I also consider which of the two might lead to abuse. Even there, alcohol fares poorly compared with marijuana. While 9 percent of pot users eventually become dependent, more than 20 percent of alcohol users do.

An often-quoted, although hotly debated, study in the Lancet ranked many drugs according to their harm score, both to users and to others. Alcohol was clearly in the lead. One could make a case, though, that heroin, crack cocaine and methamphetamine would be worse if they were legal and more commonly used. But it’s hard to see how pot could overtake alcohol even if it were universally legal. Use of marijuana is not rare, even now when it’s widely illegal to buy and use. It’s estimated that almost half of Americans ages 18-20 have tried it at some point in their lives; more than a third of them have used it in the last year.

I also can’t ignore what I’ve seen as a pediatrician. I’ve seen young people brought to the emergency room because they’ve consumed too much alcohol and become poisoned. That happens thousands of times a year. Some even die.

And when my oldest child heads off to college in the not-too-distant future, this is what I will think of: Every year more than 1,800 college students die from alcohol-related accidents. About 600,000 are injured while under alcohol’s influence, almost 700,000 are assaulted, and almost 100,000 are sexually assaulted. About 400,000 have unprotected sex, and 100,000 are too drunk to know if they consented. The numbers for pot aren’t even in the same league.

I’m a pediatrician, as well as a parent. I can, I suppose, demand that my children, and those I care for in a clinic, never engage in risky behavior. But that doesn’t work. Many will still engage in sexual activity, for instance, no matter how much I preach about the risk of a sexually transmitted infection or pregnancy. Because of that, I have conversations about how to minimize risk by making informed choices. While no sex is preferable to unprotected sex, so is sex with a condom. Talking about the harm reduction from condom use doesn’t mean I’m telling them to have sex.

Similarly, none of these arguments I’ve presented are “pro pot” in the sense that I’m saying that adolescents should go use marijuana without worrying about consequences. There’s little question that marijuana carries with it risks to people who use it, as well as to the nation. The number of people who will be hurt from it, will hurt others because of it, begin to abuse it, and suffer negative consequences from it are certainly greater than zero. But looking only at those dangers, and refusing to grapple with them in the context of our society’s implicit consent for alcohol use in young adults, is irrational.

When someone asks me whether I’d rather my children use pot or alcohol, after sifting through all the studies and all the data, I still say “neither.” Usually, I say it more than once. But if I’m forced to make a choice, the answer is “marijuana.”

Aaron E. Carroll is a professor of pediatrics at Indiana University School of Medicine. He blogs on health research and policy at The Incidental Economist, and you can follow him on Twitter at @aaronecarroll.

The Upshot is a New York Times column providing news, analysis and graphics about politics, policy and everyday life.

Researchers sought to quantify the risk of death associated with the use of a variety of commonly-used substances. They found that at the level of individual use, alcohol was the deadliest substance, followed by heroin and cocaine.

And all the way at the bottom of the list? Weed — roughly 114 times less deadly than booze, according to the authors, who ran calculations that compared lethal doses of a given substance with the amount that a typical person uses. Marijuana is also the only drug studied that posed low mortality risk to its users.

These findings reinforce drug safety rankings developed 10 years ago under a slightly different methodology. So in that respect, the study is more of a reaffirmation of previous findings than anything else. But given the currentnational and international debates over the legal status of marijuana and the risks associated with its use, the study arrives at a good time.

It’s important to note here that “safer than alcohol” doesn’t mean “safe, full stop.” Indeed, one of the more troubling lines of thought I see in some quarters of the marijuana legalization movement is that because marijuana is “natural,” or because it can be used as (non-FDA approved) “medicine,” it is therefore “safe.”

There are any number of risks associated with marijuana use. Most of these risks involve mental health issues, and most increase the earlier you start using and the more frequently you use.

That said, there are risks associated with literallyanything you put in your body. Eat too much sugar and you’re on the fast track to tooth-rot and diabetes. Take in too much salt and you’re looking at increased odds of a stroke. Psychoactive substances, like marijuana and alcohol, aren’t at all unique for having risks associated with them.

What is unique is how these substances are treated under the law, and particularly the way in which alcohol and nicotine essentially get a free pass under the Controlled Substances Act, the cornerstone of the nation’s drug policy. This study’s authors note that legislative classifications of psychoactive drugs often “lack a scientific basis,” and their findings are confirmation of this fact.

Given the relative risks associated with marijuana and alcohol, the authors recommend “risk management prioritization towards alcohol and tobacco rather than illicit drugs.” And they say that when it comes to marijuana, the low amounts of risk associated with the drug “suggest a strict legal regulatory approach rather than the current prohibition approach.”

In other words, individuals and organizations up in arms over marijuana legalization could have a greater impact on the health and well-being of this country by shifting their attention to alcohol and cigarettes. It takes extraordinary chutzpah to rail against the dangers of marijuana use by day and then go home to unwind with a glass of far more lethal stuff in the evening.

Starting in late 2013 and continuing through the 2014 elections, the US saw a surprising new breed of cannabis bills passed and signed into law by many Republican Governors. The majority of these new bills were introduced by Conservative politicians in traditionally Conservative states and allow the possession and/or study of CBD extract oil devoid of therapeutic levels of THC, reports Ladybug.com.

These restrictive laws known as “CBD-only laws” are being passed at a brisk rate. This occurred after stories of pediatric cannabis therapy for epilepsy were highlighted on CNN’s documentary Weeds, hosted by Dr. Sanjay Gupta. Even though Dr. Gupta himself has been quoted as saying he doesn’t approve of CBD-only laws , the advocacy group “Realm of Caring” featured in the documentary has been credited for much of the parent lobbying efforts behind the limited laws that have been enacted in Florida, Alabama, Iowa, Tennessee, Utah, Kentucky, North Carolina, Wisconsin and South Carolina.

CBD Legislation in Conservative States: Introduced and Supported by the GOP

In early 2014, with cannabis advocacy efforts gearing up to amend the state’s constitution in order to allow medical cannabis reform via ballot initiative, Republican lawmakers in Florida introduced legislation to legalize only low THC, high CBD strains for certain patients under certain conditions, primarily epilepsy.

Coincidentally, like Gov. Rick Scott of Florida, both Gov. Nathan Deal of Georgia and Wisconsin’s Gov. Scott Walker are also said to be wooing Conservative donor Adelson in the interests of funding an upcoming 2016 GOP Presidential bid as well. Not so coincidentally both Deal and Walker are also supporters of CBD-only laws.